This project represents a collaboration between the Texas Department of Mental Health and Mental Retardation (TDMHMR), the American Academy of Addiction Psychiatry (AAAP), The Texas Tech University Health Sciences Center - Department of Neuropsychiatry - Southwest Institute for Addictive Diseases (SWIAD), and the University of Texas College of Pharmacy. The purpose of this R13 conference grant is to develop evidence-based, consensually derived medication treatment algorithms for co-occurring mental illness and substance abuse. This will be accomplished by bringing a panel together for a two-day consensus conference. Prior to the conference, representative literature from an exhaustive literature search will be provided to all members of the consensus panel and other invited attendees. Conference participants will include two PI?s, two co-leaders, a conference coordinator, an eight-member panel of mental health and substance abuse scientists/clinicians, four consumer and advocacy group representatives. Of the two conference co-leaders, one will be a content expert and the other will be a specialist on the development of algorithms. The eight-member panel will include two bipolar specialists, two depression specialists, two schizophrenia specialists and two addiction medicine physicians (the addiction medicine physicians will be provided from within the TDMHMR system and will not be included in the honoraria or off-site preparation portion of the budget). Though not part of this current proposal, a second two-day conference will be held to develop consensus algorithms in relation to psychosocial treatments and to integrate the pharmacological algorithms with the psychosocial algorithms. Efforts will focus on developing pharmacological treatment algorithms in relation to the comorbidity of substance use and mental health disorders. As a result of the conference, the expert consensus panel on treatment of dual diagnosis will develop a medication algorithm complimenting the established Texas Medication Algorithm Project (TMAP) (A previous project with significant National implications, i.e., 13 States and the District of Columbia Planning to receive education and training in the algorithms) algorithms for treatment of the dually diagnosed consumer that will be piloted and tested at a later time. Following the conference, a re-iterative process will be used to "fine tune" the algorithm in order to arrive at a consensus document. As stated above, future research will examine integration of psychosocial and pharmacotherapy best practices on co-occurring disorders and pursue feasibility testing in the Texas public mental health system.